Proposed is a three-year collaborative, multidisciplinary, study designed to determine rates and risk factors for blood/body fluid exposure incidents in non-hospital based health care workers (HCWs). This proposal is an extension of studies we have conducted over the past decade involving hospital-based and non-hospital based HCWs. This work augments earlier research by focusing on a large and diverse range of non-hospital settings, including several for which data are particularly sparse. Given that there are both effective primary (e.g., engineering devices) and secondary (e.g., post- exposure prophylaxis) preventive strategies for managing risk and given that the extent of risk and the prevalence of risk management controls in many non-hospital settings is largely unknown, the public health significance of this problem cannot be overstated. This study is designed to address important knowledge gaps by collecting data from a wide variety of non- hospital settings, including: 1) mental disabilities facilities, 2) nursing homes, 3) drug treatment facilities, 4) AIDS clinics, 5) emergency medical services (EMS) , 6) doctors' offices and clinics, 7) hemodialysis clinics, 8) police departments, 9) correctional facilities, and 10) home health care and hospice facilities. These groups were chosen either because of published reports that they may be at high risk (e.g., EMS) or anecdotal reports of potential risk (e.g., correctional officers) or because recent data suggest that they may be at risk (police officers) or simply because there is a lack of information on this population (hospice employees). In order to meet the specific aims and goals of the study we will randomly select a sample of 6000 employees (600 per group) to receive a confidential self-administered mailed survey. Additionally, a sample of 1000 hospital based nurses will also be randomly selected to allow for occupational comparisons between hospital and non-hospital work settings. Participants will be recruited from the following agencies: (a) the New York Public Employees Federation, (b) the New York Patrolmen's Benevolent Association, (c) the New York State Nurses Association, and (d) the New York State Department of Correctional Services. Our overarching goal of the study is to identify data-driven opportunities for risk reduction. This will be accomplished by innovative Participatory Action Research teams, comprised of both researchers and study participants. An important and novel product of this study will be the development of a Risk grid a simple tool that employees and employers can use to determine exposure risk and, importantly, the steps to take to reduce that risk. This study will improve our understanding of the risks facing non-hospital HCWs and allow us to focus our energies and resources appropriately.